Durability of Blood Pressure Reduction After Renal Denervation in Resistant Hypertension: Mid‐Term Real‐World Outcomes From Kuwait

ABSTRACT

Renal sympathetic denervation (RDN) has demonstrated blood pressure–lowering efficacy in randomized trials; however, long‐term real‐world data on durability and safety beyond the first year, particularly from the Middle East, remain limited. We conducted a single‐center observational cohort study of consecutive patients with resistant hypertension undergoing RDN between February 2023 and December 2025. Baseline blood pressure was defined as the mean of three measurements obtained at separate visits. Follow‐up data were collected during routine clinical visits up to 30 months. The primary outcome was durability of blood pressure reduction. Secondary outcomes included changes in antihypertensive medications and renal safety. A total of 105 patients were included. Mean systolic blood pressure decreased from 162.1 ± 18.3 mmHg at baseline to 142.0 ± 18.9 mmHg at 12 months (−20.1 mmHg; p < 0.001), with sustained reductions observed through 30 months. Responder rates remained consistently high. Medication escalation was uncommon (6.7%), and most patients had no increase in antihypertensive burden. Renal function remained stable, with no clinically meaningful changes in creatinine or estimated glomerular filtration rate and no major procedure‐related complications. In this real‐world cohort, RDN was associated with durable blood pressure reduction over 30 months, achieved without systematic medication intensification and with preserved renal safety, supporting its effectiveness in routine clinical practice.